Obstetric outcomes after restrictive bariatric surgery: What happens after 2 consecutive pregnancies?

Doron Amsalem, Barak Aricha-Tamir, Issac Levi, Daniel Shai, Eyal Sheiner

Research output: Contribution to journalArticlepeer-review

23 Scopus citations

Abstract

Background The objective of this study was to compare the outcomes of 2 consecutive pregnancies of the same women who conceived after restrictive bariatric surgeries. Methods A retrospective study comparing consecutive pregnancy outcomes of the same women, who conceived before and twice after a restrictive bariatric surgery, was conducted. Results This study included 109 women, and therefore, 327 paired pregnancies: 109 pregnancies preceded and 218 followed restrictive bariatric surgery (87% had laparoscopic banding, and 13% had silastic ring vertical gastroplasty). Both prepregnancy and predelivery body mass index were significantly lower after bariatric surgery (36.7±4.4 versus 31. 5±5.5, P<.001; 40.6±5.5 versus 35.3±6.1, P<.001; respectively). This effect was preserved at the subsequent pregnancy (31.5±5.5 versus 31.3±6.3, P =.609, and 35.3±6.1 versus 35.1±5.9, P =.706, respectively). The rates of hypertensive disorders and gestational diabetes mellitus were significantly lower after the bariatric operation, for the first and the second pregnancy (21% versus 7.4% and 4.7%, P =.009, and 19% versus 5.6% and. 6.6%, P =.007, respectively). The rate of macrosomic newborn was significant lower in the second postbariatric pregnancy (11.1% before versus 1.1% after second pregnancy, P =.02). Using multiple logistic regression models controlling for maternal age, prepregnancy body mass index, and the type of surgery, the reduction in hypertensive disorders (adjusted odds ratio (OR).3, 95% confidence interval (CI).12-.82; P =.018 for the first postoperative pregnancy and adjusted OR.2, 95% CI.06-.64; P =.007 for the second postoperative pregnancy), and gestational diabetes mellitus (adjusted OR.2, 95% CI.06-.48; P =.001 for the first postoperative pregnancy and adjusted OR.3, 95% CI.05-.51; P =.002 for the second postoperative pregnancy) remained significant. Conclusions A significant decrease in pregnancy complications, such as hypertensive disorders and gestational diabetes mellitus, is achieved after a restrictive bariatric surgery. This improvement is maintained at the second subsequent pregnancy.

Original languageEnglish
Pages (from-to)445-449
Number of pages5
JournalSurgery for Obesity and Related Diseases
Volume10
Issue number3
DOIs
StatePublished - 1 Jan 2014
Externally publishedYes

Keywords

  • Diabetes mellitus
  • Hypertensive disorders
  • Obesity
  • Pregnancy
  • Restrictive bariatric surgery

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